Outcome of Minimally Invasive Triple-lens Surgery for Patients with Gallbladder Stones Secondary to Common Bile Duct Stones
Objective To investigate the outcome of minimally invasive triple-lens surgery for patients with gallbladder stones(GD)secondary to common bile duct stones(CBDS).Methods The data of 90 patients with GD secondary CBDS were retrospectively collected and divided into 2 groups according to different surgical protocols.45 patients treated with three mirrors combined with minimally invasive surgery(laparoscopy+choledochoscopy+duodenoscope)were classified as group A,and 45 patients treated with two mirrors combined with minimally invasive surgery(choledochoscopy+laparoscopy)were classified as group B.Perioperative indexes,visual analogue scale(VAS)scores before and after surgery,inflammatory stress response[serum leuk-1(IL-1),IL-10,tumor necrosis factor-α(TNF-α)]levels,residual stones and incidence of complications were compared between the two groups.Results The operation time,anal exhaust time and hospital stay in group A were shorter than those in group B,and the intraoperative blood loss was lower than those in group B(P<0.05).The VAS scores of group A at 3d and 7d after surgery were lower than those of group B(P<0.05).The stone retention rate in group A was 2.22%(1/45),which was lower than that in group B,17.78%(8/45)(P<0.05).Serum levels of IL-1,IL-10 and TNF-α in group A were lower than those in group B at 1d and 3d after surgery(P<0.05).The incidence of complications in group A was 4.44%(2/45)compared with 22.22%(10/45)in group B(P<0.05).Conclusion Compared with two-mirror combined minimally invasive surgery for GD patients with secondary CBDS,three-mirror combined minimally invasive surgery can further improve the efficacy of stone removal,optimize perioperative indexes,reduce the risk of postoperative complications,reduce the degree of pain of patients,and cause less inflammatory and stress reactions to the body,which can better reflect the advantages of minimally invasive surgery.
Gallstone diseaseComplicationsCommon bile duct stonesThree-mirror combinationInflammatory stress response
万方数据
维普
